Cervical Cancer

Last updated 09/02/18

Definition

Features

• Uncommon in women <25yrs
• <2% of all female cancers in Australia
• Incidence 9.8 per 100,000 women in 2012
• Mortality rate 1.9 per 100,000 in 2013

Cause

• Human Papiloma Virus (HPV) infection
• Persistent infection with oncogenic strains
• 14 stains are oncogenic: 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, 68
• Infections persist in up to 10% women
• Most are transient and clear within 1-2 years
• May progress to cervical cancer, typically takes 10-15 years
• Cause of majority of cervical cancers
• Infection may progress to high-grade squamous intraepithelia lesiosn (HSIL)
• May regress, 82.5% within 12 months
• Almost always within the transformation zone =

Risk Factors

• Lack of regular cervical screening tests
• 50% cancers in women never screened
• 28% in womne under-screened
• In utero exposure to Diethylstilboestrol (DES)
• Smoking
• Combined Oral Contraceptive Pill (COCP) use for more than 5 years
• Aged >35yrs old
• Early age of first full term pregnacy
• 3+ full term pregnancies
• Immunosupression

Associated Signs & Symptoms

Investigations

Management

• Prevention
• Primary Prevention: HPV Vaccination
• Secondary Prevention: National Cervical Screening Program (NCSP)

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References

NPS Medicine Wise: National Cervical Screening Program. January 2018